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Introduction
Every individual experiences depression at some point of time. There can be several reasons associated with depression. In fact, it can be said that it is a part of life. However when depression sustains for a prolonged period of time there may be a more serious problem. It is also not true that aging process may bring in more episodes of depression. It is linked to several mental health conditions and also with medications a person is undergoing. Researchers have also linked these disorders to genetic factors.
Main Text
Depression is a common problem, and medical assistance may be necessary for most people and therapies, drugs, or counseling can ease the pain of depression. Though depression has become a common problem especially among the elderly, often times it is ignored and is not treated. Depression is also linked with Alzheimers Disease. Scientists have been working on the links between Alzheimers Disease and depression for years together. This paper intends to discuss the relationship or association between depression and Alzheimers disease among elderly.
There are several reasons for depression in older people and is often ignores and is untreated. The signs of depression are much more likely to be dismissed as eccentricity or irritability as and when the person ages. However, it is also important to note that it is tricky to recognize the symptoms of depression. As a result of such confusions it is also possible to mistake the episodes of depression with the onset of Alzheimers disease or other brain disorders. Studies point out that mood changes and signs of depression can be caused by treatments or medicines taken by old people for hypertension or cardiac disease. Above all depression can occur at the same time as other chronic diseases as a result it becomes difficult for a doctor to diagnose depression.
According to Dr. Brent Forester, MD, director of the mood disorders division in the geriatric psychiatry research program at McLean Hospital in Belmont, Mass, Alzheimers disease and depression are probably related in ways we dont understand, and 40 to 50 % of people with Alzheimers disease get depression, but he says that depression also may be a risk factor for Alzheimers (Health Media Ventures, 2008). Depression and depression symptoms are common in persons with Alzheimer disease (Lyketsos, et al. 1997). When depression symptoms occur just before the development of AD, they may be early symptoms of the dementing process (Alexopoulos, et al. 1993).
Research on this subject began in late 1800s and the relation between depression in elderly people and dementia has been the subject of great interest (Emery and Oxman, 1992). In fact symptoms of depression have been found to occur more often in patients with Alzheimers than in the healthy elderly population (Alexopoulos , 1989).
According to another recent study there was a noteworthy relationship between depression symptoms and Alzheimers disease (adjusted odds ratio (OR), 2.13 with a 95% confidence interval [CI], 1.71-2.67). it was found that in families where depression symptoms first occurred within 1 year before the onset of Alzheimers disease, the association was higher (OR, 4.57; 95% CI, 2.87-7.31), where as in the families where the depression symptoms first occurred more than 1 year before the onset of Alzheimers disease, the association was much lower (OR, 1.38; 95% CI, 1.03-1.85).
In families where depression symptoms initially occurred more than 25 years before the commencement of Alzheimers disease, there was still a meek relationship (OR, 1.71; 95% CI, 1.03-2.82). This study concluded that depression symptoms before the beginning of Alzheimers disease are linked with the development of Alzheimers disease, even in families where initial depression symptoms occurred more than 25 years before the beginning of Alzheimers disease. Finally the results from this data showed that depression symptoms are a risk factor for later development of Alzheimers disease (Green, et al. 2003).
Studies have proven beyond doubt that there is no one cause of depression. It can be that for some people, one event can bring on the illness, for others it may be a mental disorder that that brings in the instances of depression or it may also be a part of the side effects of some medicine. There are also instances when differences in brain chemistry can affect mood and cause depression. Depression is also linked to prescription drugs or certain illnesses such as medications to treat arthritis, cardiac problems, hypertension, or cancer, Parkinsons disease, stroke, and hormonal disorders can produce cause depression as a side effect. It is also a well known fact that genetics, too, can play a role in depression (National Institutes of Health, 1998).
An analysis of risk factors for Alzheimers disease was a major objective of the Canadian Study of Health and Aging, a nationwide, population-based study. In this study it was found that increasing age, fewer years of education, and the apolipoprotein E [varepsilon]4 allele were considerably linked with increased risk of Alzheimers disease. Besides the use of nonsteroidal anti-inflammatory drugs, wine consumption, coffee consumption, and regular physical activity were also linked with a reduced risk of Alzheimers disease. However it was found that there was no statistically significant association of family history of dementia, sex, history of depression, estrogen replacement therapy, head trauma, antiperspirant or antacid use, smoking, high blood pressure, heart disease, or stroke (Lindsay et. al., 2002).
In a very recent study it was found that elderly people, who have Alzheimers disease, commonly suffer from episodes of depression. In fact in many cases, they become depressed when they recognize that their memory and ability to function are getting worse day-by-day. On the other hand it was also found that people who have had depression are more likely to develop Alzheimers disease than people who have never had depression. This study is published in the April 8, 2008, issue of Neurology. According to this study people who had experienced depression were 2.5 times more likely to develop Alzheimers disease than people who had never had depression. The possibility was even higher for individuals whose depression occurred before the age of 60; they were almost 4 times more likely to develop Alzheimers than those individuals with no depression (American Academy of Neurology, 2008).
In fact, the fear and anxiety that comes along with the diagnosis of Alzheimers disease may cause patients to become depressed. According to a new study, suffering from depression even years earlier may be a forerunner of Alzheimers. Rick factors include increasing age, a genetic link, low levels of education and a head injury earlier in life. Additionally, several people who develop Alzheimers have episodes of depression near to the time when their illness is diagnosed, or as its symptoms progress. The results from this study, took into account these previously identified risk factors and found that pattern of depression, even decades earlier, may up the risk for developing Alzheimers (Fisher Center for Alzheimers Research Foundation, 2003).
Conclusion
In conclusion, it can be said that depression can be a part of Alzheimers disease. Elderly people may have episodes of depression, but these episodes cannot be always linked to Alzheimers disease. Incidences of depression can occur for several other reasons such as diseases, medication for other conditions such as arthritis, cardiac problems, etc. Though not in all cases, but in a few cases Alzheimers disease is associated with instances of depression in elderly people.
References
Alexopoulos, G.S. et al. (1993) Geriatric depression: age of onset and dementia. Biol Psychiatry. 1993;34:141-145.
Alexopoulos, G.S. (1989) Late-life depression and neurological brain disease. Int J Geriatr Psychiatry 1989;4:187-190.
American Academy of Neurology, (2008) Depression Increases Risk Of Alzheimers Disease, Study Suggests. ScienceDaily.
Emery, V.O. and Oxman, T.E. (1992) Update on the dementia spectrum of depression. Am g Psychiatry 1992;149: 305-317.
Fisher Center for Alzheimers Research Foundation (2003) Symptoms of Depression Linked to Onset of Alzheimers, Web.
Green, et al. (2003) Depression as a risk factor for Alzheimer disease: the MIRAGE Study. Arch Neurol. May 2003;60(5):753-759.
Health Media Ventures, (2008) How is depression in the elderly different from Dementia?
Lindsay, J. et. al., (2002) Risk Factors for Alzheimers Disease: A Prospective Analysis from the Canadian Study of Health and Aging. American Journal of Epidemiology. 156(5):445-453.
Lyketsos, C.G. et al. (1997) Major and minor depression in Alzheimers disease: prevalence and impact. J Neuropsychiatry Clin Neurosci. 1997;9:556-561.
National Institutes of Health, (1998) Depression and the Elderly.
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